The potassium-competitive acid blocker vonoprazan demonstrates superior efficacy in the treatment of patients with erosive oesophagitis compared with the proton pump inhibitor lansoprazole, with the results of a small trial showing that the former more rapidly provides complete sustained heartburn relief during the first week of therapy.

Bathing with 2% chlorhexidine gluconate-medicated washcloth is cost-effective for the prevention of central line-associated bloodstream infection (CLABSI), based on a systematic review and meta-analysis of four studies.

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.

Phentermine-lorcaserin combo enhances reduction in food cravings

Audrey Abella

12 Feb 2018

The addition of the appetite suppressant phentermine to the
5-HT2C* receptor agonist lorcaserin improves control of food cravings among individuals who are under a short-term energy-restricted diet, a new study shows.

A total of 235 nondiabetic obese or overweight patients were randomized 1:1:1 to receive twice-daily lorcaserin hydrochloride 10 mg either alone or in combination with once- (LP1) or twice-daily phentermine 15 mg (LP2). Food cravings were evaluated using the Food Craving Inventory (FCI) and Control of Eating Questionnaire (COEQ) over a 12-week period.
Participants were instructed to engage in a daily 30-minute moderate-intensity exercise programme and to reduce caloric intake to 600 kcal below their estimated daily requirement.
[Obesity2018;26:332-339]

Aside from its proven efficacy against nicotine-seeking and impulsive behaviours, [ACS Chem Neurosci2015;6:1231-1240; Behav Pharmacol2014;25:775-783; Neuropsychopharmacology2012;37:1177-1191] lorcaserin has also been found to provide benefit for craving-triggered eating disorders such as emotional and binge eating.
[Int J Eat Disord1998;23:353-360; Diabetes2016;65:2943-2953]

Phentermine has been shown to reduce body weight and cravings when used in conjunction with a meal replacement system and nutritional counselling,
[Obesity (Silver Spring)2016;24:2344-2350] and when compared against naltrexone and bupropion. [Obesity (Silver Spring)2013;21:935-943] However, further trials are warranted to validate this comparison, noted the researchers.

The favourable neurobiological and behavioural responses associated with lorcaserin and phentermine appear to validate the influence of anti-obesity medications on the motivational drive to eat or reward-induced eating, said the researchers.

“[However,] if food cravings were psychological manifestations of energy depletion reflected as a metabolic need and expressed as hunger, the reduction in energy intake during the treatment period would be expected to increase food cravings,” the researchers pointed out. “[Nonetheless, our findings suggest] that lorcaserin in combination with phentermine can enhance the reduction in food cravings [despite] energy restriction.”

Apart from hunger, food cravings may also be triggered by a multitude of biologic, emotional, and cognitive processes such as menstrual-related changes, dysphoric mood states, and expectations and cognitions.
[J Affect Disord1995;34:157-164;
Appetite1991;17:187-197]

“Eating in the absence of nutritional need is evidence of a strong and overpowering control exerted by the corticolimbic structures,” the researchers pointed out. Most people would rather give in than restrain themselves from their cravings, using this to validate their food consumption. [Proc Nutr Soc2007;66:277-285] This, in turn, could lead to overeating and, eventually, overweight and obesity.
[Appetite1990;15:231-246]

These factors highlight the importance of interventional measures that can suppress cravings and subsequently help affected individuals fight their battle against overeating, underscored the researchers, who called for further trials to determine the ability of the lorcaserin-phentermine combo to address physiologic hunger and reward mechanisms, its long-term effects, and patients who would most benefit from this approach.

The potassium-competitive acid blocker vonoprazan demonstrates superior efficacy in the treatment of patients with erosive oesophagitis compared with the proton pump inhibitor lansoprazole, with the results of a small trial showing that the former more rapidly provides complete sustained heartburn relief during the first week of therapy.

Bathing with 2% chlorhexidine gluconate-medicated washcloth is cost-effective for the prevention of central line-associated bloodstream infection (CLABSI), based on a systematic review and meta-analysis of four studies.